Issue Briefs | Feb 6, 2019

State Reinsurance Programs: Design, Funding, and 1332 Waiver Considerations for States

Joel Ario and Jessica Nysenbaum, Manatt Health

Faced with a fluid federal regulatory environment, many states continue to encounter challenges in stabilizing their individual health insurance markets, including large premium increases and declining insurer participation. One solution to continued market instability is a state-based reinsurance program similar to the federal program that reduced premiums by more than 10 percent per year from 2014 to 2016. The brief provides a roadmap of policy, program design, and financing considerations for states that are contemplating development of a state-based reinsurance program under 1332 waiver authority.

The State Health Policy Highlight, State Reinsurance Programs and 1332 Waivers: Considerations for States, provides an overview of approved 1332 reinsurance waivers to date and spotlights a new 1332 application template developed by State Health and Value Strategies.


Expert Perspectives

January 7, 2025

Release of New E&E Guidance Related to Renewal Forms and Medicaid/Separate CHIP Transitions

Following the November release of guidance to support states’ efforts to verify eligibility and conduct renewals in compliance with federal Medicaid and CHIP requirements, the Centers for Medicare & Medicaid Services issued on December 20 two additional Center for Medicaid and CHIP Services Informational Bulletins (CIBs). This expert perspective summarizes the requirements outlined in the CIBs.

New CMS Guidance on Compliance Requirements for Provision of Medicaid/CHIP Services to Incarcerated Youth

On December 19, the Centers for Medicare and Medicaid Services released State Health Official (SHO) letter 24-006, “Provision of Medicaid and CHIP Services to Incarcerated Youth – FAQs,” which provides several clarifications for states on compliance expectations for implementing section 5121 of the Consolidated Appropriations Act of 2023. This expert perspective describes key clarifications addressed in the SHO letter.